Tackling the Mental Health Workforce Shortage with the Collaborative Care Model: The Power of BA-Level Care Managers
The United States is facing a profound and growing mental health workforce shortage. The Health Resources and Services Administration (HRSA) estimates that by 2036, we will be short more than 14,000 psychiatrists and tens of thousands of other mental health professionals. Primary care providers already report difficulty finding behavioral health clinicians to refer to, and patients are waiting weeks or months for therapy or psychiatric care. PCPs frequently report that they have an easier time linking patients into cardiology and oncology care compared to mental health treatment.
Against this backdrop, the Collaborative Care Model (CoCM) offers a promising, scalable, and evidence-based way to close the gap. CoCM’s team-based approach allows behavioral health expertise to be integrated into primary care — the setting where most people already seek help. CoCM also creates a profound opportunity for workforce expansion through use of Bachelor’s-level Care Managers to provide impactful behavioral health support within a well-defined scope of practice.
The Mental Health Workforce Shortage: Scope and Impact
The mental health workforce crisis is not a future threat — it’s here now.
Over 160 million Americans live in federally designated Mental Health Professional Shortage Areas.
Two-thirds of primary care providers say they cannot access timely behavioral health referrals for their patients (source: American Psychological Association)
Average wait times for psychiatric appointments often exceed 6–12 weeks, and therapy waitlists can stretch even longer. (Sun, R., Dwyer, J., Luciano, A., Li, H., Neill, E., & Busch, A. B. (2023)
The shortage is especially acute in rural and underserved communities, where recruiting and retaining licensed behavioral health clinicians can be particularly difficult.
This shortage not only delays care but also increases the risk that mild or moderate behavioral health issues will worsen into more complex, costly conditions.
The Collaborative Care Model: Expanding Access and Outcomes
CoCM is an evidence-based, team-based care model that integrates behavioral health services into primary care or other medical settings. Decades of research — over 90 randomized controlled trials — show that CoCM improves depression, anxiety, and other mental health outcomes while also being cost-effective.
CoCM’s core team and infrastructure includes:
Primary Care Provider (PCP) – maintains the patient relationship and prescribes medication as needed.
Behavioral Health Care Manager – coordinates care, provides brief interventions, and ensures patients don’t fall through the cracks.
Psychiatric Consultant – reviews cases weekly and advises the care team on treatment adjustments.
CoCM Registry - to track and monitor patients enrolled in the program. Typically managed by the Care Manager
This structure allows each team member to work at the top of their license. The PCP continues to manage overall health, the Psychiatric Consultant provides guidance and insights on differential diagnosis, clinical best practices and medication options, and the Care Manager coordinates across the team, checks in frequently with the patient and provides brief behavioral health interventions such as psycho-education and skill building. Many CoCM programs also include MA level team members who can provide brief psychotherapy in addition to other services offered through CoCM.
BA-Level Care Managers: A Workforce Multiplier
One of CoCM’s most powerful — yet often underutilized — features is the ability to staff the Care Manager role with bachelor’s-level professionals trained in behavioral health support.
In traditional outpatient mental health care, only licensed clinicians (master’s or doctoral level) provide most patient-facing interventions. This drives up cost and limits availability. But CoCM changes the equation:
Defined Scope of Practice – BA-level Care Managers are not providing psychotherapy or making independent diagnoses. Instead, they focus on tasks that keep patients engaged, supported, and progressing towards their goals.
Structured Supervision – Care Managers receive ongoing weekly case review with a Psychiatric Consultant and regular clinical supervision from a licensed behavioral health professional.
Evidence-Based Interventions – Care Managers are trained in structured, manualized approaches that fit within their scope, such as Behavioral Activation, psycho-education, problem-solving skills, and motivational interviewing techniques.
By incorporating BA-level team members into CoCM, organizations can:
Increase caseload capacity.
Improve access to timely behavioral health support.
Reduce burnout among licensed clinicians.
Create career ladders into the behavioral health field.
Increase diversity and representation in the field
The BA-Level Care Manager Role in Action
Let’s break down what BA-level Care Managers can do within CoCM:
Care Coordination
Serve as the central point of contact for patients’ behavioral health needs.
Track progress toward treatment goals using validated measurement tools like the PHQ-9, GAD-7, and others.
Manage CoCM Registry
Ensure seamless communication between the patient, PCP, psychiatric consultant, and other care team members.
Assessment of Needs
Conduct structured intake interviews to gather psychosocial, medical, and behavioral health history.
Identify social determinants of health impacting care (housing instability, food insecurity, transportation barriers).
Use measurement-based care tools to quantify symptom severity and monitor progress towards goals
Care Navigation
Help patients access specialty mental health services when needed.
Connect patients to community resources and support.
Follow up on referrals to ensure patients don’t get lost in the system.
Brief Behavioral Health Interventions & Skill Development
Within a defined scope of practice and under supervision, BA-level Care Managers can deliver:
Behavioral Activation – helping patients increase engagement in rewarding, meaningful activities.
Problem-Solving Skills – guiding patients through structured steps to address challenges.
Psychoeducation – providing information about conditions, treatment options, and self-care strategies.
Motivational Interviewing (MI) – supporting patients’ readiness to change.
These interventions are designed to be brief, structured, and focused on skill-building, not long-term psychotherapy.
Training and Support: Setting BA-Level Care Managers Up for Success
The effectiveness of BA-level Care Managers hinges on comprehensive training and ongoing support. This includes:
Initial training in CoCM workflows, measurement-based care, patient engagement, and evidence-based brief interventions.
Shadowing and role play to build comfort with patient interactions.
Weekly case review with a psychiatric consultant and clinical supervisor to ensure care quality.
Professional development opportunities to advance skills and knowledge over time.
Ongoing Clinical Supervision and Case Support: with a licensed supervisor
When implemented well, this creates a career pipeline: individuals enter as BA-level Care Managers, gain supervised clinical experience, and may later pursue advanced training and licensure — helping grow the overall behavioral health workforce.
Conclusion:
The mental health crisis demands innovation, and the Collaborative Care Model offers a proven way forward. By integrating behavioral health into primary care and empowering BA-level Care Managers to provide care coordination, needs assessment, navigation, and brief interventions, we can stretch the workforce without stretching it thin — ensuring more people get the help they need, when they need it. Just as importantly, CoCM’s broad insurance coverage and lower patient cost-sharing make it a model that doesn’t just expand capacity — it expands equitable access to mental health care for all.
